In aiming at higher specificity in clinical evaluations of the singing voice, singer perceptions were included and tested in conjunction with the voice range profile. Method: The use of a commercial ... [more ▼]

In aiming at higher specificity in clinical evaluations of the singing voice, singer perceptions were included and tested in conjunction with the voice range profile. Method: The use of a commercial phonetograph supplemented by a hand-held response button was clinically tested with 13 subjects presenting voice complaints. Singer patients were asked to press a button to indicate sensations of vocal discomfort or instability during phonation. Each press was registered at the actual position in the Voice Range Profile (VRP) so as to mark areas of difficulty. Consistency of button press behavior was assessed with a method developed previously. Results: In spite of their voice complaints, subjects did not press the button as much as healthy singers. Like healthy singers, the singer-patient group demonstrated consistent behavior but tended to press the button in completely different areas of the VRP space. The location of the presses was dominantly in the interior of the VRP and concentrated to a small fundamental frequency range. An extensive discussion examines carefully the reasons for such outcomes. Conclusion: The button augmented VRP could be a well needed resource for clinicians but requires further development and work. [less ▲]

in Lamarche, Anick (Ed.) Putting the Singing Voice on the Map (2009, March)

Purpose: As part of a project aiming at higher specificity in clinical evaluations of the singing voice, singer perceptions were included and tested in conjunction with the voice range profile. Method ... [more ▼]

Purpose: As part of a project aiming at higher specificity in clinical evaluations of the singing voice, singer perceptions were included and tested in conjunction with the voice range profile. Method: With a singer-patient group, the use of a commercial phonetograph supplemented by a hand-held response button was tested in a non-randomized study design. Button pressing during phonation resulted in marking specific regions of the voice range profile. 13 subjects, all singers with particular voice complaints, participated in enhanced voice range profile recordings. Singer-patients were asked to press a button to indicate sensations of vocal discomfort or instability during phonation. Each press was registered at the actual position in the voice range profile (VRP) so as to mark areas of difficulty. Data analysis was performed according to a method developed specifically for this use. Results: Subjects used the button during the course of tasking but did not demonstrate an increased button use when compared to a healthy group. Furthermore, numbers of button press repetitions within one task were often lower than those observed for the healthy group. The singer-patient group however demonstrated consistent behavior and tended to press the button in complete different areas of the VRP space. The location of the presses was dominantly in the interior of the VRP and concentrated within one specific range of the voice. Conclusion: The contribution of the button-VRP to clinical assessment of voice status in singers could represent a well needed resource for the clinicians but begs further development and work. [less ▲]

The objective of the study was to measure the subjective long-term effects of vocal therapy (more than 6 months) in 29 patients suffering from dysfunctional dysphonia. Four subjective measurements were ... [more ▼]

The objective of the study was to measure the subjective long-term effects of vocal therapy (more than 6 months) in 29 patients suffering from dysfunctional dysphonia. Four subjective measurements were used: one visual analog scale ranging from 0 (not efficient at all) to 100 (very efficient); one question "Is the speech therapy still efficient?," answered by yes or no; the GRB parameters of the GRBAS scale (evaluated by the patient); and the VHI-10. The results show that 76% of the patients consider that the vocal therapy they received is still efficient. On the vocal quality (G), roughness (R), and breathiness (B) parameters, we observe a high degree of satisfaction on the G parameter (median=77). The scores on the R and B parameters are lower (median R=12, S=5). Roughness is significantly correlated to the Grade (Spearman coefficient r=0.516, P=0.004), whereas breathiness is not (P=0.251, NS). The comparison of the results on the VHI-10 pre and post treatment shows a significant decrease in the grade of perceived handicap (medians 15 vs 11, P=0.017). The correlations between the judgment of the treatment's efficacy and the vocal quality is significant (r=0.623, P<0.001) as well as the correlation between the VHI-10 and the length of the treatment (r=0.416, P=0.035). The conclusion can be made that speech therapy plays an important role in long-term treatment of dysfunctional dysphonias. [less ▲]

Objective vocal changes linked to the age have been largely studied these last 20 years. However, few authors have showed an interest in the subjective evaluation of the aging voice. Our research aimed ... [more ▼]

Objective vocal changes linked to the age have been largely studied these last 20 years. However, few authors have showed an interest in the subjective evaluation of the aging voice. Our research aimed the study of the aging voice by means of the Voice Handicap Index (VHI) Jacobson et al., (1997) in 90 subjects divided into three groups: « 30 elderly subjects in a nursing home », « 30 elderly subjects living at home » and « 30 young subjects » as the control group. We compared the results from these three groups and controlled for several variables such as age, living place, personality, dependency and repetition, that can have an impact on the VHI score. The DS16 (Denollet, 1998) and the SF-36 (Ware et al, 1993) were used to test personality and dependency. Our results showed that the scores on the global and physical scales are higher for all groups at the retest (p=0,046; p=0,015). Although the VHI seems adapted to the aging subject, some improvements are suggested concerning the items addressing the professional life and social life (F8, F16, F22, E24 et E29). We also observe correlations between the three subscales (p<0,001). Concerning the DS16, the personality trait « negative affect » and « social inhibition » are correlated to the global score at the test and the retest (P=0,002 ; P =0,001 and P=0,048 ; P=0,015). Type-D personality raises the physical scores (P=0,018 ; P=0,006) and the global scores (P=0,014 ; P=0,003). Moreover, the VHI is correlated to 6 dimensions of general health related quality of life and with the global score of the SF-36 (P<0,001). The elderly subjects obtain higher functional (P=0,007 ; P=0,006), physical (P=0,009 ; P<0,001) and global (P=0,003 ; P<0,001) scores than the young subjects. Moreover, the subjects living in a nursery home obtain a higher emotional score on the univariate analysis (P=0,008 ; P=0,02) than those living at home. At the multivariate analysis, the variable « nursery home » has a significant impact on the functional score (P=0,02). Finally, a multivariate linear regression shows that the variable sex increases all the scores at the VHI (P=0,048 ; P=0,044 ; P=0,03 ; P=0,023) and the variable « dependency » (P<0,001) increases the emotional, physical and global score. Although vocal quality in the elderly might seem only slightly altered, age is a factor that increases functional, physical and global scores at the VHI. However, sex, dependency and personality type are also influencing vocal self-evaluation and can moderate the effect of age. [less ▲]

The literature shows that 20% of the teachers suffer from a vocal disorder. The researchers find frequent symptoms such as roughness, vocal fatigue and aggravation of the mean F0, peri-laryngeal pain and ... [more ▼]

The literature shows that 20% of the teachers suffer from a vocal disorder. The researchers find frequent symptoms such as roughness, vocal fatigue and aggravation of the mean F0, peri-laryngeal pain and physical discomfort. Dysphonia is more frequent in female teachers. Age, years of experience, type of subject taught and environmental factors, vocal abuse, and stress have an impact on voice. They diminish the vocal performances of these professionals which has negative financial consequences. In our study, the voice of 723 teachers were evaluated by means of the VHI (F: 634, M: 89), teaching in ordinary schools or in positive discrimination schools. Fifteen municipality in the Brussel area participated in the study. We obtain a good test retest reliability for the whole group (F: 0,774 ; E: 0.749 ; P: 0.806 ; G : 0.836 – p>0.001). The scores at the retest are significantly lower for the global scores and the three subscales (G p<0.001, F p<0.001 ; E p=0.003 et P p<0.001). Intra-scale correlation is high (F versus E : 0.434 ; F vs P :0.455 ; E vs P : 0.527). The prevalence of vocal disorders was computed with regard to past ENT and speech pathology history and actual treatments, it was evaluated to 10,5%. Teachers who had been consulting an ENT or a speech language pathologist had higher scores at the global VHI. The elder the subjects are and the more teaching experience they have, the lesser they report vocal disorders (p=0.026 et p=0.013). The variables sex (p≥ 0.063), subject taught (p≥ 0.468), smoking (p=0.757), type of school (p≥ 0.867) and class grade (p≥ 0.212) do not have a significant impact on the VHI scores. [less ▲]

The present study is the outcome of 5 former studies aiming at the adaptation of the V.H.I. to singers. We propose in this last version a V.H.I. valid for all types of singer, dysodic or not. The ... [more ▼]

The present study is the outcome of 5 former studies aiming at the adaptation of the V.H.I. to singers. We propose in this last version a V.H.I. valid for all types of singer, dysodic or not. The reliability, validity and internal coherence was evaluated on a population of 192 classical singers and 27 non singers. The comparison of the mean scores at the test and the retest shows that the results at the retest are significantly inferior for the functional scale (p=0.013) and for the global score (p=0.006). The test/re-test stability is good (ICC : Functional scale (F) : 0.869, Emotional scale (E) : 0.846, Physical scale (P) : 0.85, Global score (G) : 0.878/ Spearman’s rho F : 0.855, E : 0.834, P : 0.858, G : 0.886). The internal coherence of each sub scale is good (Cronbach’s alpha : >0.80). The correlation between the 3 subscales is quite high (FvsE : 0,613 /EvsP : 0,737/ FvsP : 0,693) which means that each scale measures a specific dimension but that they are still homogeneous. The test/re-test difference between the singers and the controls are not significant but the control group has a greater variability in their answers (Levene test : F : p<0 .001; P : p=0.009 ; G : p=0.02). Three variables increase the results : being a solist (F : p=0.046; E : p=0.002; P : p=0.056; G : p=0.006), being an amateur (F : p<0.001; E : p=0.019; P : p<0.001; G : p=0.001), having a vocal complaint (F, E, P et G : p<0.001). In conclusion, this version of the V.H.I is reliable, valid and adapted to the population of classical singers. [less ▲]

The goal of this study is the evaluation of the long-term efficiency of voice therapy (> to 6 months) in the treatment of dysfunctional dysphonia . Four subjective measurements were performed on 29 ... [more ▼]

The goal of this study is the evaluation of the long-term efficiency of voice therapy (> to 6 months) in the treatment of dysfunctional dysphonia . Four subjective measurements were performed on 29 patients: -A visual analogical scale (VAS) ranging from 0 (not efficient at all) to 100 (very efficient). -A question “Is the speech therapy still efficient?” Yes or no. -The G(rade), R(oughness) and B(reathiness) parameters from the GRBAS perceptual scale (evaluated by the patient measured on VAS). -The Voice Handicap Index-10 (VHI-10). The results show that 76% of the patients consider that the voice therapy is still efficient. In regard to G.R.B., we observe a high score for G (median: 77). The score for R is lower (median R: 12). G and R are significantly correlated (r Spearman=0.516, p=0.004), but the satisfaction of the vocal quality does not seem correlated to B (p=0,251, NS). The median values of VHI 10 shows a significant improvement from 15 to 10 (p=0,017). In addition, the correlations between the judgment on the treatment efficiency and vocal quality (r=0,623, p<0,001) and between VHI-10 and the length of treatment (r=0.416, p=0,035) are significant. The first correlation shows that the most satisfied patients when it comes to the vocal therapy are also the most satisfied when it comes to their vocal quality. The second correlation specifies that the longer the treatment, the higher the grade of vocal handicap. Voice therapy is efficient in the long term and is worth to be prolonged for difficult cases [less ▲]

This chapter tries to give a short overview of the main currents in contemporary theories of emotional expression. First, we attempt to draw a brief outline of how emotions are defined as compared to ... [more ▼]

This chapter tries to give a short overview of the main currents in contemporary theories of emotional expression. First, we attempt to draw a brief outline of how emotions are defined as compared to other affective states. Second, we try to give a short picture of the different views concerning the relationship between emotional expressions and experienced emotions, as well as the role of those expressions in human interactions. Third, the vocal and facial modes of emotion expressions are detailed. Fourth, we focus on how emotional expressions can be affected by different diseases, such as Parkinson’s disease, Steinert’s disease, and Moebius syndrome, at the vocal and the facial level. The impact of these impairments is considered in the light of the conclusions about the function of emotional expressions in society today. We conclude with a reflection about the therapy possibilities in reeducation of impaired emotional expressions. [less ▲]